Abstract B124: Barriers to care among LGBT cancer survivors: An analysis of the All of Us program

Abstract Purpose: Lesbian, gay, bisexual, and transgender (LGBT) cancer survivors may experience distinct barriers to healthcare in the survivorship period. However, limited empirical evidence documents these barriers, particularly in comparison to heterosexual, cisgender survivors. Psychosocial factors such as social support, perceived stress, and discrimination may represent useful intervention points for reducing barriers to care. Yet, their role and their relationship between barriers to care remains unexplored among LGBT cancer survivors. This study aimed to characterize barriers to care and psychosocial experiences among LGBT survivors using a national, diverse dataset. Methods: We analyzed data from 3,520 LGBT cancer survivors enrolled in the All of Us Research Program (Controlled Tier): 730 lesbian, 1,285 gay, 1,296 bisexual, and 209 transgender/nonbinary cancer survivors. Descriptive statistics summarize barriers to care and psychosocial factors, stratified by identity group. A clustering algorithm identified three barrier profiles: high- , moderate- , and low- barriers to care. Psychosocial factors of discrimination, perceived stress, and social support were compared across clusters using descriptive and summary statistics. Results: Barriers to care and psychosocial factors varied significantly across identity groups. Transgender/non-binary and bisexual cancer survivors were disproportionately represented in the high-barriers to care cluster and underrepresented in the low-barriers cluster. Conversely, lesbian and gay survivors were more frequently represented in the low-barriers cluster. Cancer survivors in the high-barriers cluster reported the highest levels of discrimination and perceived stress, alongside the lowest levels of social support. Conclusions: Barriers to care were reported by all LGBT subgroups but were most prevalent among transgender/non-binary and bisexual cancer survivors. These individuals also experienced heightened psychosocial burdens. Tailored interventions and programs addressing discrimination, stress, and social isolation are essential to reducing disparities in survivorship care. Additionally, interventions that train healthcare teams to deliver inclusive and affirming care is critical for improving outcomes. Implications for Cancer Survivors: Oncology care could be by addressing psychosocial needs and systematically reducing barriers faced by LGBT cancer survivors through inclusive, affirming care environments. Citation Format: Madeline Brown, Jennifer J. Jabson Tree. Barriers to care among LGBT cancer survivors: An analysis of the All of Us program [abstract]. In: Proceedings of the 18th AACR Conference on the Science of Cancer Health Disparities; 2025 Sep 18-21; Baltimore, MD. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2025;34(9 Suppl):Abstract nr B124.